Osgood-Schlatter Disease (Tibial Apophysitis)
Basics
Description
- Osgood-Schlatter disease (OSD) is a syndrome associated with traction apophysitis and patellar tendinosis that is most common in adolescent boys and girls.
- Patients classically present with pain and swelling of the anterior tibial tubercle.
- System(s) affected: musculoskeletal
- Synonym(s): tibial tubercle apophysitis
Epidemiology
Incidence
The incidence in girls is rising with increased participation in organized youth sports; almost equal to boys in the United States
Prevalence
- A common apophysitis in childhood and adolescence affecting athletes more frequently than nonathletes
- Estimated point prevalence of 10% in the general population aged 12 to 15 years
Etiology and Pathophysiology
Traction apophysitis of the tibial tubercle due to repetitive strain on the secondary ossification center of the tibial tuberosity; concurrent patellar tendinosis, disruption of the proximal tibial apophysis, and avulsion microfractures at the tibial tuberosity are contributing factors.
- Jumping and pivoting sports place the highest strain on the tibial tubercle. Repetitive trauma and deceleration with an eccentric load are the most likely inciting factors.
- Likely biomechanical association with tight iliopsoas, quadriceps, and hamstring muscles; increased quadriceps strength relative to hamstring strength in adolescence contributes.
Risk Factors
- Affects children and adolescents most commonly from the ages of 8 to 18 years
- Girls 8 to 13 years old
- Boys 10 to 15 years old
- OSD is slightly more common in boys than girls but likely equally common with similar sports participation.
- Early sport specialization increases the risk of OSD by 4-fold.
- Rapid skeletal growth
- Weak core stabilizing muscles
- Increased weight/BMI/height
- Patellofemoral malalignment
- Overload training volume
- Quadriceps tightness and/or shortening
- Hamstring tightness or relative weakness in ratio to the quadriceps
- Participation in repetitive-jumping sports and sports with heavy quadriceps activity (football, volleyball, basketball, hockey, soccer, skating, gymnastics)
- Ballet (2-fold risk compared with nonathletes)
General Prevention
- Avoid sports with heavy quadriceps loading (especially deceleration activities and eccentric loading).
- Patients may compete if pain is minimal.
- Increase hamstring and quadriceps flexibility.
- Reduce sports specialization.
- Increase cross-training.
Commonly Associated Conditions
- Shortened (tight) rectus femoris found in 75% with OSD
- Hamstring tightness
- Possible association with ADD/ADHD; adolescents with ADD/ADHD are at risk for other musculoskeletal injuries.
- Sinding-Larsen-Johansson apophysitis
- Calcaneal apophysitis (Sever disease)
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Osgood-Schlatter Disease (Tibial Apophysitis)." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688350/all/Osgood_Schlatter_Disease__Tibial_Apophysitis_.
Osgood-Schlatter Disease (Tibial Apophysitis). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688350/all/Osgood_Schlatter_Disease__Tibial_Apophysitis_. Accessed December 3, 2024.
Osgood-Schlatter Disease (Tibial Apophysitis). (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688350/all/Osgood_Schlatter_Disease__Tibial_Apophysitis_
Osgood-Schlatter Disease (Tibial Apophysitis) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688350/all/Osgood_Schlatter_Disease__Tibial_Apophysitis_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Osgood-Schlatter Disease (Tibial Apophysitis)
ID - 1688350
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688350/all/Osgood_Schlatter_Disease__Tibial_Apophysitis_
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -